TTNS is efficacious to treat UUI in older women.

Background: Electrical stimulation is commonly recommended to treat urinary incontinence in women. It includes several techniques that can be used to improve stress, urge, and mixed symptoms. However, the magnitude of the alleged benefits is not completely established. Objectives: To determine the effects of electrical stimulation in women with symptoms or urodynamic diagnoses of stress, urge, and mixed incontinence. Search Strategy: Our review included articles published between January 1980 and January 2012. We used the search terms "urinary incontinence", "electrical stimulation", "intravaginal", "tibial nerve" and "neuromodulation" for studies including female patients. Selection Criteria: We evaluated randomized trials that included electrical stimulation in at least one arm of the trial, to treat women with urinary incontinence. Data Collection and Analysis: Two reviewers independently assessed the data from the trials, for inclusion or exclusion, and methodological analysis. Main Results: A total of 30 randomized clinical trials were included. Most of the trials involved intravaginal electrical stimulation. Intravaginal electrical stimulation showed effectiveness in treating urge urinary incontinence, but reported contradictory data regarding stress and mixed incontinence. Tibial-nerve stimulation showed promising results in randomized trials with a short follow-up period. Sacral-nerve stimulation yielded interesting results in refractory patients. Conclusions: Tibial-nerve and intravaginal stimulation have shown effectiveness in treating urge urinary incontinence. Sacral-nerve stimulation provided benefits in refractory cases. Presently available data provide no support for the use of intravaginal electrical stimulation to treat stress urinary incontinence in women. Further randomized trials are necessary to determine the magnitude of benefits, with long-term follow-up, and the effectiveness of other electrical-stimulation therapies.

The training program improved cognitive function, muscle endurance, aerobic conditioning, and balance in older adults with MCI.

Both aerobic (AT) and resistance training (RT) are recommended as nonpharmacological treatments to prevent hypertension. However, there is a paucity of literature investigating the effects of combined exercise modes (RT combined with AT) in elderly hypertensive women. Thus, our aim was to compare the postexercise hypotension (PEH) response to both protocol models and to assess the correlation between the degree of PEH after acute and chronic training. Furthermore, we also compared several biochemical variables for each training group. Sixty hypertensive older women were randomly assigned into nonexercised control (no systematic exercise training throughout the study), eccentric RT (ERT), and traditional RT (TRT). The training programs consisted of 16 weeks of RT combined with AT. Blood pressure (BP), biochemical profiles, and 1 repetition maximum (1RM) were evaluated. There was a significant increase in high-density lipoprotein (HDL) after both training regimens pre- to posttraining (combined ERT +5% and TRT +7%; p = 0.001 for both). There was a decrease in systolic BP (SBP) (combined ERT -19% and TRT -21%; p = 0.001 for both) and diastolic BP (DBP) (-13% for both; p = 0.001 for both). There was an increase in bench press 1RM (combined ERT +54% and TRT +35%; p = 0.001 for both) and leg press 1RM (combined ERT +52% and TRT +33%; p = 0.001 for both). The magnitude of decrease in SBP after acute exercise was moderately correlated with the drop in SBP after chronic training for the ERT combined with AT group (r = 0.64). Both combined training protocols are effective in promoting benefits in health-related factors (HDL, SBP, DBP, and 1RM). Considering the lower cardiovascular stress experienced during combined ERT, this type of training seems to be the most suitable for elders, deconditioned individuals, and hypertensives.

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